Supplemental Claim Denied w/IMO, High-Level Review Next?

[lawbro]

Hi All

To make a long story short, last year the VA granted my right-knee tendinitis 10% but said my left-knee was NOT service connected. I reached out and obtained an IMO from Dr. Anaise whose IMO opined that either my left-knee tendinitis WAS service connected or that it was secondary to my service connected right-knee. 

I filed a supplemental claim at the end of June and just received the decision back that they stuck with the original decision to not grant me anything for my left-knee tendinitis, stating that it was still not service connected. 

How should I go about the next step in the process? I seem to read a lot that High-Level Reviews are a waste of time and perhaps go straight to BVA. Also, should I also look into getting an attorney for the High Level Review or just wait to see if it goes to BVA or not?

What do we believe is the best way to go about this?

[lawbro]

Thanks @JKWilliamsSr. I called Peggy yesterday and they told me that the most likely situation is that the decision letter hasn't been processed/mailed out yet. I checked VA site again today and this was posted. So it's showing two updates on back to back days, so who knows what is going on...

 

[lawbro]

New Update

It now says that The Veterans Benefits Administration is Correcting an Error. Is this good?

[Vync]

1 hour ago, lawbro said:

New Update

It now says that The Veterans Benefits Administration is Correcting an Error. Is this good?

In reality, the lack of transparency in the claims process places us in a position where we have to wait for the rating decision letter in order to know what they are doing.

From personal experience, most of my claims were granted on either appeal or reconsideration (under old system). That is a good indicator that the VA doesn't tend to get it right most of the time. Based on that, you could deduct that the VA is probably looking at fixing a mistake they made on your claim.

If you have a VSO with access to the VBMS system, they might be able to shed more light on what is going on behind the veil. If you don't have one, you can call 1-800-827-1000 and ask if they can tell you more. The only problem with that is half the time the agents at the call center will say they don't know how to do that. Even if they can tell you something, it might not be of much detail. Either way, it might be worth a shot.

 

[lawbro]

***Update***

I called Peggy today to see if they could tell me any information on what's going on since it shows "VA made a new decision" and that "The Veterans Benefits Administration is correcting an Error". She told me that a letter was mailed to me today that basically states the "Error" was not taking my IMO into account of the previous decision. That now my claim was being moved back into the "Development" stage and that the current date they have for completion estimates October 2020... I was really shocked she told me what the letter addresses, it was my understanding they weren't supposed to do that?

Hoping for a positive outcome but being told it was essentially now being restarted at ground-zero of the claim doesn't give me much confidence. The HLR rater initially told me that I should have my decision as soon as last week, I didn't think she meant the decision to sent it back to the developmental stage. Anybody have any experience with this? This goes back to May 2018 so I was hoping I was close to finally closing this.

 

[Vync]

They are (supposedly) not allowed to tell veterans the outcome of a final rating decision (good or bad). Perhaps there is a different policy for interim decisions like this.

That is definitely a positive development. Expect that estimated date of completion to change. On my last CUE claim, they temporarily assigned a long-term completion date when they claim was either awaiting evidence or action from another department at the VA. If you were to call them back and ask if it is assigned to a VSR, the may tell you it is waiting to be picked up.

[lawbro]

***UPDATE***

Just received word that the HLR worked and they have raised my rating %. Here comes 22 months worth of backpay. As soon as it drops I'll be donating 10% to Hadit. It feels great to be able to give back to a community that has helped me so much. You guys are the real MVPs.